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Medicaid Midterm Election Update

Midterm Election Update: Medicaid Changes

Major federal changes to Medicaid eligibility and financing from the 2025 reconciliation law are coming, including new work requirements that will affect millions of Medicaid enrollees. KFF’s fact sheet provides an overview of what has changed, what is still ahead, and what the public thinks about Medicaid heading into the midterms.

Medicaid State Fact Sheets 2024

Medicaid State Fact Sheets

What share of people in your state are covered by Medicaid? States varywidely in how many and which residents they cover and how much they spend. KFF’s state Medicaid fact sheets offer a snapshot of data and information on coverage, access, financing, and politics for all 50 states and DC. Get data for your state.

Medicaid work requirements

Nebraska Renewal Outcomes Among Individuals Subject to Medicaid Work Requirements

Early Medicaid Work Requirement Insights From Nebraska

This brief describes the verification process for Medicaid work requirements in Nebraska and examines early data on outcomes for individuals subject to work requirements. Among Medicaid enrollees renewing coverage under Nebraska's work requirements, 93% met the requirements or qualified for an exemption —while 7% lost coverage.

Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements

KFF’s interactive tracks key data and policies that will affect how states implement Medicaid work requirements, which are required under the 2025 budget reconciliation law starting in January 2027. The tracker includes state-level data on Medicaid enrollment and renewal outcomes as well as current state enrollment and renewal policies. The Congressional Budget Office estimates that the 2025 reconciliation law will increase the number of people who are uninsured in 2034 by 10 million. Coverage losses from Medicaid work requirements account for over half, or 5.3 million, of the increase in the number of uninsured.

understanding medicaid

Medicaid Financing: The Basics

Medicaid represents $1 out of every $5 spent on health care in the U.S. This brief examines key questions about Medicaid financing and how it works.

Medicaid and Provider Taxes

This brief explores how rules governing provider taxes are changing because of the 2025 reconciliation law and the regulations implementing that law, and summarizes which changes may affect each state.

5 Key Facts About Medicaid and Hospitals

This brief explains the role of Medicaid for hospitals, including how much spending on hospital care comes from Medicaid and how Medicaid expansion has impacted hospital finances.

Medicaid home Care

Medicaid Home Care/HCBS Survey

Since 2001, KFF has administered regular surveys of states about their Medicaid home- and community-based services (HCBS) programs. The survey is sent to officials administering Medicaid HCBS programs in all 50 states and the District of Columbia.

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  • Mapping Hospital Employment By State

    Issue Brief

    Changes to Medicaid funding, eligibility and enrollment could impact hospital finances. These interactive 50-state maps show the number of hospital employees by state and how hospital employment ranks among industry subsectors. Hospitals employed 6.7 million people in 2023, and more than 100,000 people in each of 23 states.

  • 5 Key Facts About Medicaid and Pregnancy

    Issue Brief

    This brief examines Medicaid’s pregnancy and postpartum coverage and its support for strengthening and improving maternal health outcomes.

  • The Spotlight Is on Medicaid Cuts, But the ACA Marketplaces Could See a One-Third Cut in Enrollment

    From Drew Altman

    In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes are on the big Medicaid cuts being proposed in the House,” he writes, “significant changes are also being proposed that together would dramatically reduce enrollment in the ACA Marketplaces.”

  • Again, No Medicaid

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman explains why Medicaid, despite former President Donald Trump's silence on the topic, warrants greater attention given the potential for drastic changes or cuts to it should Republicans win control in the election.

  • KFF Health Tracking Poll February 2025: The Public’s Views on Potential Changes to Medicaid

    Feature

    Amid discussion of changes to the Medicaid program, most of the public say that Medicaid is important to their local communities. About two in ten favor cuts to Medicaid spending. Support for Medicaid cuts remain low even among typically conservative groups such as Republicans, Trump voters, and those living in rural communities. The poll also gauges the impact of arguments for and against Medicaid work requirements and reductions to federal spending on ACA expansion.

  • A quote in green text against a white background reads, "The math is conclusive: Major cuts to Medicaid are the only way to meet the House’s budget resolution requirements. There are a myriad of options available for cutting Medicaid, but all of them would leave the states facing  difficult choices to raise revenues or cut spending."

    The Math is Conclusive: Major Medicaid Cuts Are the Only Way to Meet House Budget Resolution Requirements

    Quick Insights

    The CBO letter confirms early expectations, finding that over the next 10 years, 93% of non-Medicare spending in the E&C [House Energy & Commerce Committee] jurisdiction is from the federal share of Medicaid spending…Even if E&C eliminated all non-Medicaid and CHIP spending, the committee would need to cut federal spending on Medicaid and CHIP by well over $700 billion, nearly 10% of projected spending.

  • This is an image of text that are an excerpt of Larry Levitt's quick take that reads: " Once Republicans in Congress get specific about Medicaid cuts, it will become more tangible and clearer who will be affected. Changes to the status quo in health care rarely get more popular when the details get filled in. We saw that with the Clinton health plan in the 1990s, with the Affordable Care Act (ACA) when it initially passed, and with the 2017 effort to repeal the ACA."

    The Rubber is About to Hit the Road on Medicaid Cuts

    Quick Insights

    Once Republicans in Congress get specific about Medicaid cuts, it will become more tangible and clearer who will be affected. Changes to the status quo in health care rarely get more popular when the details get filled in.

  • 10 Things to Know About Rural Hospitals

    Issue Brief

    This brief explores data about rural hospitals’ financial health and stability at a time when Congress is considering potential federal budget cuts. It examines the prevalence of rural hospitals, their characteristics and finances, federal support for these facilities, and the potential impact of reductions in Medicaid and Medicare spending that are under consideration.

  • With or Without ACA Repeal, ACA and Medicaid Cuts are Looming

    Perspective

    In this JAMA Health Forum post, Executive Vice President Larry Levitt explores why the incoming Trump administration and Republican majorities in Congress are likely to pursue budget cuts in Medicaid and the Affordable Care Act and why such efforts are likely to boost the number of uninsured Americans.